Secondary lesions with examples

Question 1

What are secondary lesions?

Answer 1

They typically elvove from a primary lesion or as a consequence to the patients activities (scratching, infections, …).

Question 2

Which are the secondary lesions?

Answer 2

• Scale
• Crust
• Lichenification
• Fissure
• Erosion
• Ulcer
• Scar
• Atrophy

Question 3

What is a scale?

Examples?

Answer 3

Visible fragments of the outermost layer (stratum corneum) of the skin as it is shed (desqumating) from the skin. This happens when it proliferates faster than normal. A rash consisting of scales is called papulosquamous exanthema.

Examples:

Solar dermatitis

Psoriasis vulgaris

Pityriasis rosea

Question 4

What is a crust?

Examples?

Answer 4

Drying of liquid debris (serum, blood, pus) on surrounding skin. Can be due rupture of vesicles or pustules.

Examples:

Impetigo

Ecthyma

Question 5

What is lichenification?

Examples?

Answer 5

Thickening of the skin surface over time. Increase of skin markings: wrinkles, skin lines, … Usually due to chronic scratching or rubbing of an area.

Examples:

Atopic eczema/dermatitis

Chronic contact dermatitis

Question 6

What is a fissure?

Examples?

Answer 6

It is the linear splitting of the skin surface extending in the epidermis to the dermis or deeper. Usually caused by repetitive trauma to the skin. Usually associated to other skin diseases.

Examples:

Crohn’s disease

Hailey-hailey disease

Question 7

What is an erosion?

Examples?

Answer 7

Loss of superficial epidermis by friction or pressure. Sharply-defined, red and oozes serum. Always heals without a scar.

Examples:

Bullous pemphigoid

Pemphigus vulgaris

Contagious impetigo

Question 8

What is an ulcer?

Examples?

Answer 8

Loss of skin extending into dermis and deeper. Always occur within pathological altered tissue and thus always secondary phenomena. They can be the continuation of erosisons. Always resolves with a scar.

Examples:

Leg ulcer

Grade III burn

Ecthyma

Question 9

What is a scar?

Examples?

Answer 9

Fibrous regeneration tissue due to wound repair in the skin replacing normal skin after injury of the dermis and/or the subcutis.

Examples:

Scarring alopecia

Trauma

Keloid

Question 10

What is atrophy?

Examples?

Answer 10

Partial or complete wasting away (shrinking, involution, incomplete development) of the skin

Examples:

Lichen sclerosus et atrophicus

Scar

Steroid atrophy

Chronic discoid lupus erythematosus